Get Active Get a Prize!

It’s everywhere! The reward (or bribe) for physical activity participation program.  If you log X amount of physical activity you can get points. In time, this “activity currency” can be redeemed for a prize.

Low level prizes might be a water bottle (and rarely are they BPA free, but that’s another story). Next comes the ubiquitous T-Shirt, usually emblazoned with a company logo. Often is a reduction in health insurance premiums or club memberships. The best of those “prizes” also require continued attendance at the destination for a base number of times per week or per month.

How motivating are these reward programs for the long term? Again and again there is a drop out rate close to 80% of those enrolled in these sorts of programs in 4-6 months.  For many of these programs, approximately 70% of a group enroll and approximately 40% actually initiate the activity.  When the 80% drop out, the remaining active participants end up being those who would have been active anyway – they were fitness seekers in the first place.

Leveraging social networks is currently very popular to accelerate engagement,” says LuAnn Heinen, vice president of the National Business Group on Health in Washington, D.C. “It is the theory underlying the challenges and competitions we’re seeing, as well as the use of health champions,” or peer leaders among the ranks who can foster change. Ths does not mean we must all pop a Facebook page online and call it good.  The magic begins when we connect what people already do:

  1. Talk to neighbors in the back yard
  2. Visit over coffee or lunch
  3. Chat during walks, while waiting for kids at practice or while shopping
  4. And then connect those conversations to physical activity behaviors and habits.

In addition to encouraging participation and creating positive buzz around healthful behaviors, such programs have scientific evidence to back them up, as research more strongly links social, occupational and environmental factors to the tendency of  a “connected” group of people to gain weight over time. So before you load up on prizes and monetary/material rewards, it might be a good idea to talk with the Wellness Gaming specialists at HCD.  We can connect you with experts and leaders in this exciting – and complex- field of wellness gamification and social connection.

Such is the crux of one popular theory put forth by Dr. Nicholas Christakis, a professor at Harvard University, and James Fowler, a professor in the School of Medicine at the University of California in San Diego.
They contend that there’s a social contagion factor to the spread of obesity—a finding summarized in a 2007 article in The New England Journal of Medicine.
In their research, they evaluate the weights and body mass indices of more than 12,000 people who are part of the Framingham Heart Study—a decades-long analysis of heart disease in a Massachusetts town. The study was launched by the National Heart Institute in 1948 and has tracked generations of participants.

Using statistical models, Christakis and Fowler sifted through the years’ worth of data, eventually creating a map of how 5,124 people were connected—a web of 53,228 ties between friends, family and work colleagues.
Next, they analyzed the data, beginning by tracking how and when residents became obese. From this came a diagram of the entire social network—with each resident represented as a dot that grew bigger or smaller as the person gained or lost weight for 32 years, from 1971 to 2003. What they found was that obesity occurred in clusters—with weight gain actually spreading to nearly 40 percent of the social network of friends, siblings, spouses and neighbors.

Specifically, obesity seemed to spread like a virus through social ties; if one person became obese, the likelihood that his mutual friend would follow suit increased 171 percent, the study shows. And the effect didn’t stop there; it appeared to skip links, Christakis says.
A person was about 20 percent more likely to become obese if a friend of a friend became obese—even if the “connecting” friend didn’t put on weight. A person’s risk of obesity went up about 10 percent even if a friend of a friend of a friend gained weight, the analysis shows.

“We’ve always lived in these interconnected webs of relationships where we influence people—not only those we’re directly connected to, like family, but also our friends, their friends and their friends’ friends,” Fowler says.

Evidence for other transmissible traits and behaviors emerge from the same data set; many are described in Connected: The Surprising Power of Our Social Networks and How They Shape Our Lives (Little, Brown and Co., 2009). In the book, Christakis and Fowler write that “everything we think, feel, do or say can spread far beyond the people we know,” and that “you may not know him personally, but your friend’s husband’s co-worker can make you fat.”

“The question is, ‘Are there interventions that we can exploit to take advantage of the social network phenomenon to improve health?’ ” Christakis asks. “The answer is yes, and one of the dynamics is that group interventions are more effective than individual” ones.
For example, physical activity interventions that provide peer support—that modify the behavior of people within their social networks—are more successful than those that don’t.
“People are connected,” he says. “Their health is connected.”

Some thought-provoking links (all slide decks have narrative available on request)

HCD WellnessGaming

HCD Home Blog: Wellness Gaming

A HUGE Community Wellness Game

Gamification of Conversations

Empowerment: The reward for physical activity and exergames

Does Work make you fat?

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